JENNIFER RENEE WISE (NPI# 1255326252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255326252 |
| Entity Type | Individual |
| Full Name | JENNIFER RENEE WISE |
| Credential | MD |
| Practice Address |
2821 Daggett Ave Ste 200 Klamath Falls OR 97601-1106 |
| Mailing Address |
2865 Daggett Ave Klamath Falls OR 97601-1106 |
| Practice Telephone | 5412748400 |
| Practice Fax Number | 5412748405 |
| Mailing Telephone | 5412748400 |
| Mailing Fax Number | 5412748405 |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2020-02-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD192270 | OR | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 12016 | NH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NH | AETNA PROV # | 3369774 | 01 |
| NH | CIGNA PIN | 5796012 | 01 |
| NH | TUFTS PIN | 012016 | 01 |
| NH | RR MEDICARE PIN | P00179641 | 01 |
| NH | RAN PIN | 30367Y | 01 |
| NH | HPHC PIN | 6000361 | 01 |
| NH | DOL W/C PIN | 101115805 | 01 |
| NH | 30203784 | 05 | |
| NH | ANTHEM ACES PIN | 01YP05180NH01 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 275 Mammoth Rd, Suite 4, Manchester, NH 031094133 | 6036244380 | 6036244805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285181347 | Jennifer Wise | Specialist/Technologist | 310 Neely Ferry Road, Mauldin, SC 29662 | 2016-09-07 |
| 1699811471 | Jennifer Lea Wise | Chiropractor | 4931 S Route 59, Unit 121, Naperville, IL 60564-5705 | 2007-01-29 |
| 1982189981 | Jennifer Wise | Behavior Technician | 125 Wellness Way, Hot Springs, AR 71913-6478 | 2018-09-26 |
| 1467836742 | Jennifer Wise | Nurse Practitioner | 114 Saundersville Rd, Hendersonville, TN 37075-8967 | 2015-07-16 |
| Street Address |
2821 DAGGETT AVE STE 200 |
| City | KLAMATH FALLS |
| State | OR |
| Zip Code | 97601-1106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083614630 | Darcy R. Butcher | Nurse Practitioner | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1106 | 2005-07-26 |
| 1679181382 | Sky Lakes Medical Center | General Acute Care Hospital | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2020-07-20 |
| 1659905669 | Sean Peter Mcgarry | Physician Assistant | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2020-02-28 |
| 1992355770 | Leslie Ann Driggers | Nurse Practitioner | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1106 | 2019-09-13 |
| 1174172316 | Ahjainene Tiahna Hamilton Barkalow | Physician Assistant | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2019-09-10 |
| 1750850327 | Julie M Lee | Nurse Practitioner | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1106 | 2018-11-13 |
| 1114494705 | Danielle Smestad | Nurse Practitioner | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2018-11-01 |
| 1174043517 | Maria Johnson | Family Medicine | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2017-06-27 |
| 1811420409 | Hannah Kauffman Jantzi | Family Medicine | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2017-04-10 |
| 1912439506 | Matthew Peters | Family Medicine | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1130 | 2017-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205487311 | Socorro Guadalupe Alcala- Peres | Case Manager/Care Coordinator | 2210 N El Dorado Ave, Klamath Falls, OR 97601 | 2019-09-20 |
| 1033760053 | Melissa Ann Roy | Counselor | 2210 North El Dorado, 2210 North El Dorado, Klamath Falls, OR 97601 | 2019-09-20 |
| 1134699721 | Kristin Asta Ragnarsson | Speech-Language Pathologist | Plum Ridge Care 1401 Bryant Williams, Klamath Falls, OR 97601 | 2018-11-27 |
| 1730667445 | Nancy Leota Baley | Pharmacist | Sky Lakes Outpatient Pharmacy, 2865 Daggett Street, Klamath Falls, OR 97601 | 2018-08-03 |
| 1336511260 | Patricia Blauvelt | Occupational Therapy Assistant | 1401 Bryant Williams Dr, Klamath Falls, OR 97601 | 2015-10-30 |
| 1598160814 | Christopher S. Turner | Counselor | 635 Main St., Klamath Falls, OR 97601 | 2014-10-29 |
| 1134472582 | Whole Person Care Family Practice | Family Medicine | 2301 Mountainview Blvd. Ste B, Klamath Falls, OR 97601 | 2012-10-23 |
| 1255692687 | Billy Dean Vermaas | Physical Medicine & Rehabilitation | 204 N. 10th Street, Klamath Falls, OR 97601 | 2012-06-01 |
| 1407140700 | Wendell C Heidinger Md | Family Medicine | 2301 Clairmont Drive, Klamath Falls, OR 97601 | 2011-06-03 |
| 1740573146 | Klamath Youh Department Center | Community/Behavioral Health | 2210 Eldordo Ave, Klamath Falls, OR 97601 | 2011-05-18 |
| Find all providers in zip 97601 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891866786 | William Clay Mccord Jr. | Internal Medicine | 2631 Crosby Ave, Klamath Falls, OR 97603-0000 | 2006-11-13 |
| 1366489569 | Amr R. Hassan | Internal Medicine | 2610 Uhrmann Rd, Klamath Falls, OR 97601 | 2006-05-31 |
| 1053371666 | Charles Keith Cofas | Internal Medicine | 2640 Biehn St Ste 4, Klamath Falls, OR 97601-1181 | 2006-03-27 |
| 1982698221 | Slavka Kucinska | Internal Medicine | 2865 Daggett Ave, Klamath Falls, OR 97601 | 2005-09-01 |
| 1770970998 | Katie Martin | Internal Medicine | 2821 Daggett Ave Ste 100, Klamath Falls, OR 97601-1106 | 2015-04-26 |
| 1518353549 | Christopher Michael Brown | Internal Medicine | 2821 Daggett Ave Ste 100, Klamath Falls, OR 97601-1106 | 2015-04-07 |
| 1679867071 | Abdulmetin Dursun | Internal Medicine | 2865 Daggett Ave, Klamath Falls, OR 97601-1106 | 2011-06-02 |
| 1477708790 | Chin Hee Jun | Internal Medicine | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1106 | 2008-12-01 |
| 1659539245 | Bassel Michel Choufani | Internal Medicine | 3001 Daggett Ave Ste 101, Klamath Falls, OR 97601-1114 | 2008-05-30 |
| 1699943845 | Michele C Rushton | Internal Medicine | 2821 Daggett Ave Ste 200, Klamath Falls, OR 97601-1106 | 2008-02-11 |
| Find all providers in KLAMATH FALLS | ||||
| City | KLAMATH FALLS |
| Zip Code | 97601 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.